Diagnostic value and misdiagnosis analysis of tetralogy of Fallot by prenatal echocardiography / 中华实用儿科临床杂志

ABSTRACT

Objective To evaluate the diagnostic value of prenatal echocardiography in fetus with tetralogy of Fallot(TOF),and to analyze the reason of misdiagnosed in order to improve the echocardiographic diagnosis.Methods A retrospective echocardiographic review of 36 fetuses with TOF confirmed by prenatal magnetic resonance imaging (MRI) or postnatal echocardiography.Results Among 36 cases of TOF fetuses,31 cases (86.1 ％) were diagnosed correctly by echocardiography,and in the remaining 5 cases,4 cases(11.1％) were misdiagnosed [2 cases misdiagnosed as ventricular septal defects (VSD),2 cases misdiagnosed as double outlet of right ventricles],and 1 case (2.8％) was missed diagnoses at 20 weeks gestation and confirmed as TOF at 36 weeks gestation based on the echocardiographic findings of malalignment type VSD,overriding aorta,pulmonary stenosis,and right ventricular hypertrophy.Malalignment type VSD,overriding aorta,and pulmonary stenosis were observed in 31 cases with TOF diagnosed by prenatal echocardiography,right ventricular hypertrophy was observed only in 6 cases.The most common associated anomalies were tricuspid regurgitation in 13 cases(36.1％),aortic insufficient in 6 cases(16.7％),absent pulmonary valve in 4 cases(11.1％),right-side aortic arch in 4 cases(11.1％),persistent left superior vena cava in 3 cases(8.3％),and complete atrioventricular septal defect in 1 case (2.8％).Conclusions Combining visualization of TOF in four-chamber view,outflow tract view,and three vessels view,TOF can be accurately diagnosed by prenatal echocardiography.